Type of Membership:

Single Membership -$15.00 __________

Family Membership-$20.00 __________

Name of Member: ________________________________________________________

Address: ________________________________________________________________
City: _____________________________ State: ________Zip Code: ________________

Telephone Home: ______-______________Cell Phone: ______-___________________

Email Address:_______________________________@__________________________

Age (as of January 1^st 2009):________________________________________________

*Family Memberships fill out information below. *Family membership includes father, mother, any children 18 and under living under their roof and any child that the adult has legal guardship. Please list ages of January 1^st 2009. Please list first and last name

Relationship must be Spouse, and children 18 and under

Name:______________________________________Age:_____Relationship:_________

Name:______________________________________Age:_____Relationship:_________

Name:______________________________________Age:_____Relationship:_________

Name:______________________________________Age:_____Relationship:_________

Name:______________________________________Age:_____Relationship:_________

Name:______________________________________Age:_____Relationship:_________

We like to inform our members of events and changes. What is your preferred contact method? Email or Postal Mail (Please circle one)

Are you interested in__Horse shows__ Trail Riding__ Driving  Drill Team __ Cookouts__ English__Western__ Hunter/Jumper__ Dressage__Parades __  Contesting__ Reining__ Clinics__ Seminars __Cowboy Shoots

Total:_____________ Paid on____________2009

Cash______Check______#___________________

Received by: ______________________________